Healthcare Provider Details

I. General information

NPI: 1992029508
Provider Name (Legal Business Name): LUISA GUZMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 1ST AVE APT 4E
NEW YORK NY
10021-1309
US

IV. Provider business mailing address

1483 1ST AVE APT 4E
NEW YORK NY
10075-1309
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-7904
  • Fax:
Mailing address:
  • Phone: 212-639-7904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number0371411
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: